title: Analysis of outcomes in treatment of obstructive sleep apnea in infants.
abstract: OBJECTIVE
  To investigate interventions used for treatment of obstructive sleep apnea (OSA) in infants.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Patients 3 to 24 months old at the time of diagnosis of OSA by polysomnography (PSG) were studied at a tertiary care children's hospital. The main outcome measures were demographic data, PSG data, intervention data, subjective results of interventions, and medical comorbidities.
  
  
  RESULTS
  Of the 295 patients included, 196 (66%) were males and 99 (34%) were females. The most common interventions with average age at the time of intervention were: adenotonsillectomy, 115 patients (31.8%, 22.3 months); adenoidectomy, 82 patients (22.5%, 17.7 months); observation, 76 patients (20.9%, 12.8 months); supplemental oxygen, 27 patients (7.4%, 11.7 months); continuous positive airway pressure (CPAP)/bilevel positive airway pressure (BiPAP), 18 patients (4.9%, 15.6 months); tonsillectomy, 16 patients (4.4%, 25.7 months); and tracheostomy, six patients (1.7%, 15.3 months). In the youngest patients (3-5 months of age), 89.3% of interventions were nonsurgical and 10.7% were surgical. In the oldest patients (older than 24 months), 17.5% of interventions were nonsurgical and 82.5% were surgical. Subjective improvement following intervention was highest after adenotonsillectomy. The intervention with the greatest percentage decrease in apnea-hypopnea index (objective efficacy) was tracheostomy, followed by CPAP/BiPAP. Average time from diagnosis to intervention was 35.5 days for nonsurgical interventions and 92.4 days for surgical interventions.
  
  
  CONCLUSIONS
  Observation was the most common nonsurgical intervention and the most common intervention in patients younger than 12 months. Adenotonsillectomy was the most common surgical and overall intervention. Adenotonsillectomy had the greatest subjective efficacy, and tracheostomy had the greatest objective efficacy.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Jacob G
authors.initials: JG
authors.lastname: Robison
authors.forename: Caleb
authors.initials: C
authors.lastname: Wilson
authors.forename: Todd D
authors.initials: TD
authors.lastname: Otteson
authors.forename: Sangeeta S
authors.initials: SS
authors.lastname: Chakravorty
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Mehta
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000367:Age Factors; D001784:Blood Gas Analysis; D002675:Child, Preschool; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010101:Oxygen Consumption / Q000502:physiology; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D017286:Polysomnography / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D014068:Tonsillectomy / Q000379:methods*; D014139:Tracheostomy / Q000379:methods; D016896:Treatment Outcome
keywords: Infant; adenotonsillectomy; obstructive sleep apnea